Feasibility, Safety, and Effectiveness of a Novel Mobile Application in Cardiac Rehabilitation - The 66th Annual Conference of the Israel Heart Society & The Israel Society of Cardiothoracic Surgery

Irene Nabutovsky ^1,2 Saar Ashri ¹ Amira Nachshon ¹ Riki Tesler ² Yair Shapiro ² Evan Wright ³ Brain Vadasz ³ Amir Offer ⁴ Liza Grosman-Rimon ⁴ Robert Klempfner ^1,5

¹Cardiac Prevention and Rehabilitation Institute, Leviev Heart Center, Sheba Medical Center
²The Department of Health Systems Management, Faculty of Health Sciences, Ariel University
³The Ruth and Bruce Rappaport Faculty of Medicine, Technion American Medical School
⁴the Azrieli Faculty of Medicine in the Galilee, Baruch Padeh Medical Center
⁵Sackler Faculty of Medicine, Tel Aviv University

Background: Cardiac rehabilitation (CR) is underutilized globally despite evidence of clinical benefit. Major obstacles for wider adoption, include distance, travel-time and interference with daily routine. Tele-rehabilitation can potentially address some of these limitations, enabling patients to exercise in their home environment or community. The aim of this study was to evaluate the clinical and physiological outcomes as well as adherence to tele-cardiac rehabilitation (tele-CR) in patients with low cardiovascular risk.

Methods: A total of 22 patients with established coronary artery disease participated in a 6-month tele-CR program. Datos Health, a novel digital health application and care-team dashboard were used for remote monitoring, communication and management of the patients. The primary objective of the study was to assess exercise capacity as determined by exercise stress test, using a treadmill before and following the 6-month intervention.

Results: Following the 6-month tele-CR intervention, there was a significant improvement in exercise capacity, assessed by estimated Metabolic Equivalents (METS) with an increase from 10.6±0.5 to 12.3±0.5 (P=0.002). High-density lipoproteins (HDL) levels significantly improved, whereas low-density lipoproteins (LDL), triglyceride (TG) glycosylated hemoglobin (HbA1c), systolic (SBP) and diastolic (DBP) blood pressure levels were not significantly changed. Exercise adherence was consistent among patients, with more than 63% of patents who participated in a program of moderately intense exercise for 150 minutes per week.

Conclusion: Patients who participated in tele-CR adhere well to the exercise program and attained clinically significant functional improvement. Tele-CR program is a viable option for populations that cannot, or elect not to participate in center based tele-CR programs.